Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …

Partnering To Advance Health Equity And A Welcome Opportunity To Gather: Proceedings From The 28th Annual Conference Of The Health Care Systems Research Network, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

In April 2022, the Health Care Systems Research Network (HCSRN) — a consortium of 20 research institutions affiliated with large health systems spread across the United States (and one in Israel) — held its 28th annual conference in Pasadena, California, with 275 researchers, health care colleagues, and external academic partners in attendance. With a conference theme of “Promoting Collaboration and Partnerships to Advance Health Equity,” the scientific program was assembled by a multisite planning committee with input from representatives of informal local host Kaiser Permanente Southern California. Objectives of the annual conference are to showcase scientific findings from HCSRN projects …

Project Ankle-Brachial Index: Implementation Of An Evidence-Based Peripheral Artery Disease Protocol, Melaney Banks

Doctor of Nursing Practice Projects

Background: Peripheral artery disease (PAD) is a narrowing or blocking of the arteries due to plaque buildup, which prevents oxygen, blood, and other nutrients from getting to the legs. When this buildup reaches a certain point, it becomes atherosclerosis, which is more prevalent in a smoker. Smoking intensifies the problem of plaque buildup if an individual already suffers from PAD. When an individual smokes, the nicotine causes the arteries to constrict and narrow, reducing blood flow further. The ankle-brachial index (ABI) is a simple, cost-effective diagnostic test to identify the presence of PAD which will improve patient outcomes.

Purpose: This …

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not …

Emerging Trends In Healthcare Driven By The Covid-19 Pandemic: A Review From Health Informatics Perspective., Venugopal Mudgundi, Bhargav Desai, Farhad Nasar

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic is the first of its kind to hit the world in the modern information age. People working in healthcare across the globe have harnessed technological advances and modern digital tools in innovative new ways. This has brought specific, more recent trends in healthcare delivery to the forefront. In this review, we present a collection of articles that highlight some of the emerging trends in healthcare driven by the COVID-19 pandemic and that have the potential to transform healthcare in the coming decades. We provide a brief commentary on the opportunities and challenges for each trend.

Feasibility And Effectiveness Of A Prehabilitation Program Prior To Breast Cancer Surgery: A Critically Appraised Topic, Emma Choi, Alissa Lee, Kayla Woods, Morgan Mills, Carol Houston

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our project is to determine the feasibility and effectiveness of a prehabilitation (prehab) program for patients undergoing breast cancer surgery as compared to only receiving post-surgical rehabilitation. Our clinical mentor has recently obtained certification as a lymphedema specialist and is assisting with the opening of an outpatient mastectomy clinic through the Methodist University systems. Through our research process, we critically appraised two Level II articles, two Level III articles, and one Level IV article. Positive outcomes related to the feasibility were identified, however there is limited significant evidence supporting the effectiveness of the intervention. We recommend using …

Effects Of Sensory Intervention On Neurological Development In The Neonatal Intensive Care Unit: A Critically Appraised Topic, Paulina Bullard Mot/S, Emma Gadberry Mot/S, Siham Sherif Mot/S, Virginia Strawn Mot/S, Courtney Travis Mot/S, Delaney Weller Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains four research articles from both national and international journals. Study designs include a randomized clinical trial, a randomized control trial, a systematic review and meta-analysis, and an integrative review. All studies relate directly to components of the evidence-based practice question and will be used to recommend sensory intervention for neurological development of premature infants in the neonatal intensive care unit (NICU). One of the articles describes statistically significant effects. One of the articles describes both statistically significant and non-statistically significant effects of sensory intervention on neurological development of premature infants in the NICU. The other two …

Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of four research articles. Study designs include two randomized control trials, one cohort design, and one systematic review. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population who have hip replacements in a rehabilitation setting.

Effect Of Early Mobilization On Length Of Hospital Stay In Covid-19 Patients: A Critically Appraised Topic, Ashlee Hodges, Anna Claire Briscoe, Anna Beth Willoughby, Carlton Hubbard, Nathan Smith

Master of Occupational Therapy Student Critically Appraised Topics

For this project, we created a critically appraised topic to study the effects of early mobilization on length of hospital stay in COVID-19 patients in the ICU.

Utilizing Training And Educational Materials To Increase Hand Hygiene Compliance Of Healthcare Providers Participating In Cesarean Sections, Christopher Natividad

Master's Projects and Capstones

Surgical site infections (SSIs) are one of the most common complications of Cesarean section (C-section) procedures. The incidence of SSIs after C-section procedures at Hospital X has increased in each of the past three years. The Labor and Delivery (L&D) unit at Hospital X performs approximately 4,500 C-sections each year. Observation of these procedures illustrated a lack of adhesion to hand hygiene policies and protocols. This quality improvement project involved informing staff members of the poor hand hygiene compliance rates, and re-educating them regarding proper hand hygiene behavior using flyers, emails, and addressing them at shift change. Data collection focused …

Rates And Perceptions Of Covid-19 Vaccination From University Of Mississippi Students, Josie Parham

Honors Theses

The trials, tribulations and triumphs of the global COVID-19 pandemic are impacted by and are a product of behaviors that occur at the level of nations, states, cities and, ultimately, communities. In the wake of the development of safe and effective vaccines against SARS-CoV2, the virus responsible for the pandemic, the significance of the vaccine is closely linked to the number of individuals that receive the vaccine. To date, surveys have measured sizable variations in vaccination rates between nations, states, cities, and communities. Focusing on events that have transpired in one such local community, the present study (i) measured the …

Dexmedetomidine To Reduce Ponv, Amanda Johnson Srna, Joshua Lawrence Srna, Staci Martinez Srna, Taylor Mayberry Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative nausea and vomiting (PONV) contribute to patient dissatisfaction, discomfort, adverse outcomes, and increased healthcare costs. Despite current protocols that aim to reduce PONV by prevention/antiemetic administration, PONV continues to be a common manifestation in many postoperative patients (Elvir-Lazo et al., 2020). This scoping review aimed to analyze available research on the efficacy of dexmedetomidine to reduce perioperative opioid requirements and PONV.

Methods Synthesis of this scoping review began with a systematic approach to search databases and identify eligibility criteria articles. Of the 21 articles that met criteria, a synthesis table was formed to visualize the qualitative (smoking status, …

Lead Poisoning, Education, And Advocacy For Prevention (L.E.A.P.) Study, Stephen Acheampong, Britney Aderinto, Zander Turcich, Ali Harb

Rowan-Virtua Research Day

Lead poisoning has been regarded as a major threat due to its irreversible and harmful effects. This includes severe cognitive and developmental impairments, especially in children.

Over the years, the CDC has reduced the benchmark for acceptable blood lead levels (BLL) from 10 μg/ml to 3.5 μg/ml to allow for earlier intervention and prevention.

Despite increased awareness and government programs that lead to a decline in mean blood levels across the country, testing for elevated BLLs, especially in low-income households, continues to be disproportionately lower.

Impact Of Behavioral Health Consultant Intervention On Health Outcomes In An Integrated Primary Care Setting, Arpita Suri, Attiyah Zaheer, Christine Leroy, Robert Steer, Bhavin Shah, Sahil Zaveri, Shideh Doroudi

Rowan-Virtua Research Day

Integrated Primary Care Models are fast gaining popularity, and often being advocated as an important step in enhancing patient care within a primary care setting. Several studies have shown a positive impact of Behavioral Health Consultant (BHC) intervention in terms of patient satisfaction, improvement in patient symptom scores and global mental functioning. However, additional studies are needed to assess if integrated behavioral health consultations can demonstrate measurable outcome improvements to quantify the benefits of this approach, related to some of the most commonly seen and treated medical diseases in a primary care setting. This study aims to measure three outcomes: …

What Motivates Patients To Enroll In A Naloxone Co-Prescribing Program?, Christina Kanagawa, David Aloisio, Eshani Choksi, Manasa Gowda, Tyler Klecha, Charles M. Defendorf

Rowan-Virtua Research Day

Patients were contacted via phone call to establish knowledge of and prescription status regarding naloxone. They were then invited to enroll in a research study consisting of two online surveys.

The patients who had been prescribed naloxone by the time the study had started ranked being persuaded by a medical professional as being the most important reason for accepting the naloxone prescription.

Insufficient data collected during the six-week time frame to draw statistically significant conclusions about what motivates patients to receive naloxone co-prescriptions.

Correlations seen in this study are interesting and warrant further investigation.

Understanding Changes In Mortality With Implementation Of Safe Injection Sites, Shubh Bhambri

Rowan-Virtua Research Day

The purpose of this study is to analyze mortality due to overdose in areas that have implemented supervised injection sites and understand what factors these facilities affect that can lead to a change in outcomes.

Literature Review: Incidentalomas In Emergency Medicine - How Often Are They Reported And Are Patients Informed?, Mohammad Rattu, James Espinosa, Alan Lucerna, James Lee

Rowan-Virtua Research Day

The purpose of this proposed study is to look at the rate of incidental findings on CT scan in a community hospital setting, as well as to look at the rate of documentation of communication of the findings to the patient and referral for follow-up to primary care or to a specialty follow-up.

Transferring Patients To A Higher Level Of Care, Chiquita Rockiemore Rn, Msn, Olubunmi Osinloye Bsn, Rn, Angela Uta Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

The purpose of this study is to determine whether the transfer of critically ill patients, who require a higher level of care, to another facility impacts morbidity and mortality within 24-72 hours post transfer

Esmolol Compared To Fentanyl On Hemodynamic Effects: A Scoping Review, Anna Mccleskey Bsn, Rn, Srna, Landon Mcdonald Msn, Rn, Cnl, Tim Moore Bsn, Rn, Srna, Jamie Pitcock Bsn, Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose The purpose of this DNP project is to compare the efficacy of esmolol to fentanyl in attenuation the hemodynamic response associated with direct laryngoscopy.

Specific Aims Compare the effects of esmolol to fentanyl on patient heart rate during laryngoscopy. Compare the effects of esmolol to fentanyl on patient mean arterial pressure during laryngoscopy.

Dexmedetomidine Vs. Propofol In Postoperative Delirium Prevention, Jaclyn Burnett Rn, Srna, Montana Betts Rn, Srna, Christhian De Ochoa Rn, Srna, Maciej Chec Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative delirium (POD) is an acute neurological condition affecting large numbers of surgical patients in various practice settings. Patients suffering from this condition face postoperative complications, increased lengths of stay, and tremendous financial burden. Understanding the contributing factors for POD, and how adjustments in intraoperative agents can prevent or reduce the incidence, is a crucial aspect of anesthesia practice. This scoping review will examine associations between POD and the intraoperative use of propofol versus dexmedetomidine with general anesthesia.

Methods Studies in this review were limited to peer-reviewed literature, published in medical and nursing journals within the last five years. …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background: Infants admitted to the NICU are disproportionately born to low-income families. This, combined with unique financial challenges of their long-term stay, may predispose caregivers to food insecurity (FI). FI among caregivers has far reaching implications for the health of infants who are already vulnerable related to comorbidities from their NICU stay.

Methods: Using the Iowa model to successfully engage key stake holders and begin a small pilot study, a randomized preintervention chart audit was performed (n=30) to evaluate if FI was identified by NICU Social Worker (SW). The FI screening tool was administered by nursing to a separate group …

Advantages Of Early Utilization Of Palliative Care In The Pediatric Icu: A Scoping Review, Shelby Noel Cain Bsn, Rn, Cpn, Dana Pabalate Zimmerman Msn, Rn, Charis Elizabeth Oji Msn, Aprn, Cpnp-Pc/Ac, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Abstract Purpose/Background Despite the increased use of palliative care in adults, only a tiny percentage of children with life-limiting illnesses or life-threatening conditions receive palliative care before dying. Palliative care has low utilization, and consults are often made late in a child’s hospitalization or diagnosis. Palliative care remains underutilized among hospitalized pediatric patients resulting in unnecessary treatments, costly and lengthy hospitalizations, and deaths occurring in the intensive care unit (ICU) rather than at home. The purpose of this scoping review is to evaluate current literature to determine the use and effect of pediatric palliative care, specifically, whether consultation of palliative …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Interventions To Improve Adherence To Recommended Diabetic Retinopathy Screening In Adult Patients With Diabetes Mellitus: A Scoping Review, Clare Anderson Bsn, Rn, Dnp, Fnp, Sarah May Bsn, Rn, Dnp, Fnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Diabetic retinopathy (DR) is the leading cause of blindness in adults. Current guidelines recommend that all patients with type 2 diabetes mellitus (T2DM) have a DR screening (DRS) upon diagnosis of T2DM and then annually, but the adherence rate is only approximately 60%. This scoping review aims to evaluate the effectiveness of primary care providers (PCPs) employing strategies to increase compliance with annual DRS among adult patients with T2DM.

Methods Between September 2021 and January 2022, a literature review was performed to collect studies evaluating interventions to increase adherence to DRS. Individual searches of PubMed, SCOPUS, and CINAHL were …

Prevention Of Diabetes-Related Hospital Readmission Following Initial Diagnosis Of Diabetes In Patients Over The Age Of Fifty: A Scoping Review, Nathan Miller Dnp, Agacnp, Fnp, Jasmine Harris Dnp, Fnp, Michael Clardy Dnp, Agacnp, Diana Dedmon Dnp, Acnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: By reviewing multiple studies related to the treatment of patients with new diagnoses of diabetes, this scoping review will endeavor to determine which interventions, when implemented for patients over 50 years old which are newly diagnosed with type 2 diabetes, can decrease the likelihood of hospital readmission related to diabetes within 90 days when compared with those patients who did not receive or participate in follow-up.

Methods: For resources to be eligible to review they had to be from 2015 or after. Studies selected included patients over the age of 50 newly diagnosed with type 2 diabetes subject to …

Increasing Colorectal Cancer Screening Adherence: A Scoping Review, Megan E. Billingsley Bsn, Rn, Tiameria T. Ford Bsn, Rn, Mikayla E. Vican Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Rates have steadily increased in recent years due to high rates of obesity, smoking, and sedentary lifestyles. Screening for the disease can lead to early detection and reduced morbidity/mortality, yet screening rates remain low. Existing literature is extensive in discussing methods to increase CRCS adherence; therefore, a scoping review allows for increased understanding of barriers to CRCS and how to address those barriers to increase screening compliance.

Methods A literature search was completed from September 2020 to October 2021. Multiple databases were used, including …

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

Evaluation Of The Effectiveness Of An On-Site Referral System To Increase Mammography Screening Compliance: Scoping Review, Piper Black, Elizabeth R. Upchurch, Ravina Patel, Vicki Chandler Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Early detection of breast cancer through routine mammography screenings has increased the 5-year survival rate to 99% for women with cancer in the localized stage (American Cancer Society, 2021). However, this survival rate is lessened amongst women in the rural population (Leung et al., 2014). This scoping review investigates health disparities to identify interventions that improve mammography rates for women residing in rural areas.

Methods A scoping review was performed using an exclusive search for peer-reviewed mammography and rural health sources. Search phrases included were, ('Mammogram screening in rural areas'), ('Health care disparities in rural areas'), ('Secondary prevention in …